The oral microbiome during cancer chemotherapy and its role in oral mucositis

癌症化疗期间的口腔微生物组及其在口腔粘膜炎中的作用

• 批准号: 8514567
• 负责人: Patricia Diaz
• 金额: $ 75.62万
• 依托单位: UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-13 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8514567
• 关键词: Adverse effects; Affect; Blood; Cells; Characteristics; Chemotherapy-Oncologic Procedure; Clinical; Clinical Research; Communities; Complex; Complication; Consensus; Development; Environment; Epithelial; Epithelial Cells; Erythema; Event; Foundations; Gene Chips; Gene Expression; Gene Expression Profile; Goals; Head and neck structure; Health Care Costs; Immune response; Immunosuppression; Incidence; Individual; Individual Differences; Infection; Inflammatory; Inflammatory Response; Injury; Lead; Lesion; Literature; Metabolic Pathway; Modeling; Molecular Profiling; Morbidity - disease rate; Mucositis; Mucous Membrane; Oral; Oral mucous membrane structure; Organism; Outcome; Pain; Pathogenesis; Pathway interactions; Patients; Personal Satisfaction; Play; Predisposition; Prevalence; Prevention strategy; Preventive; Radio; Risk; Risk Assessment; Role; Route; Salivary; Sampling; Severities; Signal Pathway; Stream; Structure; Submucosa; Surface; Swab; Taxon; Tissues; Treatment Protocols; Treatment outcome; Ulcer; Wound Healing; base; cancer radiation therapy; cancer therapy; chemotherapy; cytotoxic; cytotoxicity; functional disability; improved; microbial; microbiome; microorganism; microorganism growth; mortality; neutrophil; next generation sequencing; novel; oral commensal; oral infection; oral microbiome; oral mucositis; pathogen; patient population; prospective; public health relevance; pyrosequencing; response; saliva composition

DESCRIPTION (provided by applicant): Oral mucosal injury ("mucositis") s a common complication of cytotoxic cancer therapies consisting of painful, debilitating lesions in the oral mucosa that impact patient well-being and cancer treatment outcomes. While the cancer treatment regimen is the triggering event for development of the lesions, it is likely that the complex microbiota associated with oral mucosal surfaces affects the course and/or severity of mucositis. Furthermore, little information is available on the effects of cytotoxic cancer therapy on the oral microflora despite the high incidence of bacterial and fungal oral infections and systemic dissemination of intraoral organisms during oncologic treatment. Thus, the overall aims of this project are to investigate the effects of chemotherapy on the oral microflora and to identify a possible association between the oral microbiome and the clinical signs and molecular signatures of oral mucositis. To accomplish these goals we will conduct a prospective clinical study in which we will first characterize via amplicon-based pyrosequencing the bacterial and fungal oral microbiomes during the course of chemotherapy in a population of patients known to present variable susceptibility to oral mucositis and in comparison to healthy controls. Secondly, we will evaluate oral neutrophil presence and function in order to determine whether suppression of the local innate immune response contributes to shifts in the diversity and structure of the oral microbiome during chemotherapy. Thirdly, we will investigate via gene expression microarrays the oral mucosa response to chemotherapy in order to identify the major epithelial cellular pathways that characterize oral mucositis and evaluate their relationship with the fungal and bacterial microbiome. Since microorganisms could be an important contributing factor in the inflammatory cascades that lead to tissue destruction, we hypothesize that subject variability and/or chemotherapy-induced changes in the oral microbiome are associated with oral mucositis outcomes. We also hypothesize that qualitative and/or quantitative changes in the microbiome during the course of chemotherapy are inversely related to neutrophil presence and activity in the oral environment. Thirdly, we hypothesize that specific microbial taxa are associated with shifts in epithelial gene expression during chemotherapy. We expect to answer the following questions: Does the oral microflora change during the course of chemotherapy, and do these changes precede or follow the occurrence of mucositis? Are inter-individual differences in the oral microbiome associated with the incidence and/or severity of mucositis? Are changes in the microbiome diversity or structure associated with diminished neutrophil function and availability in the oral environment? Are there specific mucosal gene expression signatures characteristic of oral mucositis? Are these mucosal signatures associated with a specific microbiome? By answering these questions we expect to improve the understanding of the pathobiology of oral mucositis, which could in turn lead to the development of multi- factorial models of risk assessment and provide the foundation for novel multi-pronged preventive strategies. PUBLIC HEALTH RELEVANCE: This project will improve our understanding of the oral side effects of oncologic therapy. The results will allow us to develop comprehensive preventive approaches to improve the well-being of patients and cancer treatment outcomes.

描述（由申请人提供）：口腔粘膜损伤（“粘膜炎”）是细胞毒性癌症疗法的常见并发症，该疗法包括疼痛，使人衰弱的粘膜病变，影响患者的健康和癌症治疗结果。尽管癌症治疗方案是病变发展的触发事件，但与口腔粘膜表面相关的复杂微生物群可能会影响粘膜炎的病程和/或严重程度。此外，尽管细菌和真菌口腔感染的发生率很高，并且在肿瘤学治疗期间，细菌和真菌口腔感染的发生率很高，并且在肿瘤学治疗期间对术中生物的全身传播。因此，该项目的总体目的是研究化学疗法对口腔菌群的影响，并确定口腔微生物组与口服粘膜炎的临床体征和分子特征之间的可能关联。为了实现这些目标，我们将进行一项前瞻性临床研究，在该研究中，我们将在化疗过程中以基于扩增子的焦磷酸测序在化学疗法期间，在化学疗法期间，在化学疗法过程中，已知的患者群体对口服粘膜炎的可变敏感性以及与健康对照组相比。其次，我们将评估口腔中性粒细胞的存在和功能，以确定局部先天免疫反应的抑制是否有助于化学疗法期间口服微生物组的多样性和结构的变化。第三，我们将通过基因表达微阵列进行调查，口服粘膜对化学疗法的反应，以确定表征口腔粘膜炎的主要上皮细胞途径，并评估其与真菌和细菌微生物组的关系。由于微生物可能是导致组织破坏的炎症性级联反应的重要因素，因此我们假设受试者的变异性和/或化学疗法诱导的口服微生物组的变化与口腔粘膜炎的结局有关。我们还假设化学疗法过程中微生物组的定性和/或定量变化与口腔环境中的中性粒细胞的存在和活性成反比。第三，我们假设特定的微生物类群与化学疗法期间上皮基因表达的变化有关。我们期望回答以下问题：化学疗法过程中口腔微生物是否会发生变化，这些变化是否先于或遵循粘膜炎的发生？口腔微生物组的个体间差异是否与粘膜炎的发生率和/或严重程度相关？微生物组多样性或结构的变化是否与口腔环境中嗜中性粒细胞功能和可用性降低相关？是否存在口服粘膜炎的特定粘膜基因表达特征？这些粘膜签名是否与特定的微生物组相关？通过回答这些问题，我们期望提高对口腔粘膜炎病原体学的理解，这反过来又可能导致风险评估的多阶段模型，并为新型多管齐下的预防性策略奠定了基础。 公共卫生相关性：该项目将提高我们对肿瘤疗法的口腔副作用的理解。结果将使我们能够开发全面的预防方法，以改善患者的福祉和癌症治疗结果。

项目成果

Subgingival Microbiome Shifts and Community Dynamics in Periodontal Diseases.

• DOI: 10.1080/19424396.2016.12221035
• 发表时间: 2016-07
• 期刊: Journal of the California Dental Association
• 作者: P. Diaz;A. Hoare;B. Hong

Influence of DNA extraction on oral microbial profiles obtained via 16S rRNA gene sequencing.

• DOI: 10.3402/jom.v6.23990
• 发表时间: 2014
• 期刊: Journal of oral microbiology
• 影响因子: 4.5
• 作者: Abusleme L;Hong BY;Dupuy AK;Strausbaugh LD;Diaz PI
• 通讯作者: Diaz PI

Using high throughput sequencing to explore the biodiversity in oral bacterial communities.

• DOI: 10.1111/j.2041-1014.2012.00642.x
• 发表时间: 2012-06
• 期刊: Molecular oral microbiology
• 影响因子: 3.7
• 作者: Diaz PI;Dupuy AK;Abusleme L;Reese B;Obergfell C;Choquette L;Dongari-Bagtzoglou A;Peterson DE;Terzi E;Strausbaugh LD
• 通讯作者: Strausbaugh LD

Ecological Therapeutic Opportunities for Oral Diseases.

• DOI: 10.1128/microbiolspec.bad-0006-2016
• 发表时间: 2017-08
• 期刊: Microbiology spectrum
• 影响因子: 3.7
• 作者: Hoare A;Marsh PD;Diaz PI
• 通讯作者: Diaz PI

Redefining the human oral mycobiome with improved practices in amplicon-based taxonomy: discovery of Malassezia as a prominent commensal.

通过改进基于扩增子的分类学实践重新定义人类口腔真菌组：发现马拉色菌作为一种重要的共生菌。

• DOI: 10.1371/journal.pone.0090899
• 发表时间: 2014
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Dupuy AK;David MS;Li L;Heider TN;Peterson JD;Montano EA;Dongari-Bagtzoglou A;Diaz PI;Strausbaugh LD
• 通讯作者: Strausbaugh LD